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Organization
RM NP IN ADULT HEALTH P C
Active
Organization
RM NP IN ADULT HEALTH P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RIGINA MATATOVA NP (OWNER)
(917) 361-9333
Entity
Organization
Contact information
Practice address
6535 QUEENS BLVD STE 200, WOODSIDE, NY 11377-5769
(718) 426-4242
Mailing address
6535 QUEENS BLVD STE 200, WOODSIDE, NY 11377-5769
(718) 426-4242
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
NULL
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/22/2025
Last updated
01/22/2025
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